| NPI | 1285291013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: SC 82220) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC 82220) |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2025-12-18 |